The study investigated the efficacy of a combination of serum ferritin (SF), homocysteine (Hcy), C-reactive protein (CRP) and the ultrasound parameter CAP in predicting metabolic dysfunction-related steatotic liver disease (MASLD). 206 patients with MASLD admitted to the hospital from November 2021 to November 2023 and 106 healthy subjects without underlying diseases participated. Univariate analysis showed significantly higher levels of SF, Hcy, CRP and CAP in the MASLD group compared to the healthy group (p < 0.05). Multivariate logistic regression confirmed that SF, Hcy, CRP and CAP are independent predictors of MASLD (p < 0.05). The ROC curve showed that the area under the curve for the combination of these indicators is 0.941, which is significantly higher than for individual parameters. The combined application of SF, Hcy, CRP and CAP has a high predictive efficiency for MASLD and can be used for early clinical diagnosis.